title: Trends in bacterial resistance in a tertiary university hospital over one decade.
abstract: The objective of this study was to investigate bacterial resistance trends, infection sites and the relationship between resistance and admittance to the intensive care unit (ICU). A total of 53,316 bacteria identified between 1999 and 2008 were evaluated. Multidrug resistance was characterized when gram-negative bacilli (GNB) presented resistance to two or more classes of antibiotics. Gram-positive cocci (CPC) were assessed for resistance to penicillin, oxacillin and vancomycin. GNB were the most common (66.1%) isolate. There was a 3.7-fold overall increase in multidrug resistant GNB over the study period; Acinetobacter baumanii and Staphylococcus aureus were the most prevalent. Highest increases were recorded for Klebsiella pneumoniae (14.6-fold) and enterococci (73-fold). The resistance rates for GNB and GPC were 36% and 51.7%, respectively. Most multidrug resistant GNB and GPC were recovered from ICU patients (p-value<0.001). Vancomycin-resistant enterococci were isolated during this decade with an increase of 18.7% by 2008. These data confirm the worldwide trend in multidrug bacterial resistance.
authors.affiliation: Department of Infectious, Parasitary and Dermatology Diseases, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil. gongora@famerp.br
authors.forename: Fernando Góngora
authors.initials: FG
authors.lastname: Rubio
authors.forename: Viviane Decicera Colombo
authors.initials: VD
authors.lastname: Oliveira
authors.forename: Regina Mara Custódio
authors.initials: RM
authors.lastname: Rangel
authors.forename: Mara Corrêa Lelles
authors.initials: MC
authors.lastname: Nogueira
authors.forename: Margarete Teresa Gottardo
authors.initials: MT
authors.lastname: Almeida
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001938:Brazil; D024901:Drug Resistance, Multiple, Bacterial; D006094:Gram-Positive Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D063128:Tertiary Health Care
chemical_list: D000900:Anti-Bacterial Agents
keywords: Bacteria; Multiresistance; Trends